|
|
|||||
|
|||||
| Path: Main Street : NewsWeek : Archive : Ethics Q & A Articles : Article |
This is an archive of CharityVillage NewsWeek.
To find a word on the page, use your browser's "find" feature (CTRL-F or CMD-F).
Please note: While we ensure that all links and e-mail addresses are
accurate at their publishing date, the quick-changing nature of the
web means that some links to other web sites and e-mail addresses may
no longer be accurate.
To view other articles in the archive, use our Chronological Index.
Ethics Q & A
February 5, 2007
By Jane Garthson, Garthson Leadership Centre
The dilemma:
I counsel clients and am required to explain a range of options. My clients are usually under considerable stress and not at their best for making sensible choices. It often seems they make the worst possible choice. I compare notes with friends in other social service and health agencies and they see the same thing. Why can I not limit the choices to a couple of good options, or just make the choice for them?Jane's Response:
Are you the one who will live with the consequences for the rest of your life? Are you the one responsible for the others most affected by the choice, such as the children of an abused woman? Then it is not your choice, no matter how frustrating the decisions may be.
Besides, taking an important choice out of their hands may further reduce the self-confidence and self-esteem they will need to cope with other aspects of their lives. We humans have the right to make a wrong decision, and live with it.
I do still see nonprofits that operate in a paternalist mode. For example, they may condone the way staff and volunteers say to a client, “so we are going to choose ______ as your goal for the next ten sessions, aren’t we?” having given no other choice or even time to think. Yes, the clients in question often have cognitive or communications difficulties, but sometimes staff avoid making the effort to communicate.
And others allow parents and caregivers to make the choice without even consulting the actual client, even when the client is a teenager or adult clearly able to explain their preferences to someone with a little patience. As children, we are usually told that patience is a virtue. I have trouble remembering that myself when faced with onerous workloads and too little time, but it remains true.
From my own past volunteering, I have noticed that many people with disabilities want chances to challenge themselves, improve their skills and test themselves, in situations where caregivers are more focused on safety and security. The clients speak (or otherwise communicate) the language of risk management; the caregivers use the language of risk avoidance.
Organizations need to have repeated dialogues on how to resolve such values conflicts, and be clear about whose views should prevail in different types of situations. Most things in life that are worthwhile involve some level of risk. When we try to learn something new, we may fail or be laughed at, but the alternative is never learning anything new at all. Safety is very important, but over-protection is not.
When we work with those that absolutely cannot communicate - such as forests or wetlands - then we bear an extra responsibility to closely monitor the effect of choices and take corrective action if our choice is causing adverse effects.
An animal in a shelter can use its voice and body language to show what it objects to and what it likes. We must sometimes inflict short-term pain, such as a needle before an operation, but should not keep an animal in long-term distress. Barbaro, a wonderful Thoroughbred racehorse, was put down last week by an owner who realized the horse was in pain and his treatment was not working. Every animal in our care deserves that sort of decision, no matter the heartbreak to us.
With human clients, sometimes it is a matter of explaining the pros and cons more completely. You do not have to be completely neutral about someone deciding to go back to an abuser, or refusing essential health treatment. And you can make the desirable choices easy, with a minimum of paperwork and red tape, and the less desirable choices difficult. Some places ask clients to sign a waiver noting that their choice is contrary to the professional advice they have received. However, you may not be in a position to keep them from just walking out. Maybe you can also make undesirable choices less risky, such as helping the client apply for a restraining order or learn where to seek a second opinion on their health care options.
Know your organizational policies on this before making such changes; I do not know the details of your workplace. If you think the policies are wrong, suggest improvements. Your organization may also have policies about alerting the police or taking other action when a clearly unsafe decision has been made. Check with your manager.
The most important thing is to keep the doors wide open for that client to return, perhaps after a night’s sleep, or when their health deteriorates, or when they have been beaten again. If you are too judgmental, they will not want to return. Make sure they know and really believe they are welcome to get in touch, to walk back through the door, to change their mind, as soon as they are ready. Given the same range of options again, they may be ready to make the choice you hoped for the first time.
***********
Because nonprofit organizations are formed to do good does not mean they always are good in their own practices. Send us your ethical questions dealing with volunteers, staff, clients, donors, funders, sponsors, and more. Please identify yourself and your organization so we know the questions come from within the sector. No identifying information will appear in this column.
To submit a dilemma for a future column, or to comment on a previous one, please contact help@charityvillage.com. For paid professional advice about an urgent or complex situation, contact Jane directly.
Disclaimer: Advice and recommendations are based on limited information provided and should be used as a guideline only. Neither the author nor CharityVillage.com make any warranty, express or implied, or assume any legal liability for accuracy, completeness, or usefulness of any information provided in whole or in part within this article.
|
|||
